Advanced ovarian cancer in women aged ≥80 years: a retrospective single-center study

Approximately one-third of ovarian cancers occur in women older than 70 years, and this proportion is expected to increase with population ageing. Complete cytoreductive surgery remains a key component of treatment. However, elderly patients are frequently undertreated due to concerns about frailty and surgical morbidity. The primary objective of this study was to assess the feasibility and outcomes of cytoreductive surgery in carefully selected patients aged ≥80 years with advanced ovarian cancer.

We conducted a retrospective study including patients aged ≥80 years treated for advanced ovarian cancer (FIGO stages III-IV) between 2017 and 2024 at the Oscar Lambret Cancer Center, Lille, France. Clinical characteristics, geriatric parameters, treatment strategies, surgical procedures, and oncological and postoperative outcomes were collected.

Among 638 patients treated for advanced ovarian cancer during this period, 42 were aged ≥80 years (median: 82). Thirteen patients (31.0%) underwent cytoreductive surgery, of whom 9 (69.2%) underwent interval debulking procedures after neoadjuvant chemotherapy. No gross residual disease was achieved in 11 patients (84.6%). The median hospital stay was 11 days (IQR, 8-11). All patients lived at home before cytoreductive surgery, and 12 (92.3%) were discharged directly home postoperatively, while one patient was transferred to a nursing home. In the cytoreductive surgery group, the 2-year progression-free survival and overall survival rates were 55.9% (CI95%, 23.4-79.3) and 81.5% (CI95%, 43.5-95.1), respectively.

In patients aged ≥80 years with advanced ovarian cancer, cytoreductive surgery is feasible in carefully selected individuals. Importantly, surgical management should remain as simple as possible, after neoadjuvant chemotherapy, if necessary, with the aim of achieving no gross residual disease while preserving functional independence.